Maui AMPS~127, +2~41, +2.25~49, +3.75~64, +12~ 122

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LDB

LDB

Member Since 2013
When I took Maui to the vet on July 15, the vet took his blood glucose reading with an AlphaTRAK 2. It was 362. I finally have a meter now at home (Arkray Glucard) and when I tested him this morning after he ate and had his insulin shot, the reading was 127. Yesterday, in my first attempt to test, I got a reading of 98 shortly after he'd eaten a little midday snack.

I know the human meter is going to be a bit different from the pet meter, and that some time has passed, but does this big of a difference seem right to you all? My vet has suggested that readings in the office may not be as accurate because of how nervous the cat gets.

Thoughts?
 
Re: Big difference in BG numbers home vs vet

You said the vert used an "Accutrak 2." Did yo mean an "AlphaTRAK 2" The AlphaTRAK is a pet meter.
Very frequently BGs taken at the vet are higher than at home because stress can rains BG 100 points or so.
Those reading/BGs are good.
How much insulin are you giving and what kind of insulin, Are you feeding only canned?
 
Re: Big difference in BG numbers home vs vet

Yes, he used the pet meter - Alpha Trak. Sorry about that! I'll see if I can fix my post.

Dosage is 1 unit, twice a day. Only canned, low carb foods as listed in my signature.
 
Re: Big difference in BG numbers home vs vet

Here are some glucose reference ranges used for decision making using a human glucometer:

< 40 mg/dL
- Treat as if HYPO
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s; if not on insulin, this can be safe.

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Re: Big difference in BG numbers home vs vet

These are great numbers - it could be the change of food has brought him down to better numbers!. A normal cat is 50-130 so I definately wouldnt shoot at these numbers.

We recommend newbies dont shoot under 200 until they have the data to know how the cat will behave when shooting low.


Wendy
 
Re: Big difference in BG numbers home vs vet

Just tested again -- 2 hours after first meal and insulin shot. His reading was 42. Seems low, but I've never done a curve, so I don't know what to expect on how low he can/will go. I gave him a bit of food and tested again. 49. Should I be concerned?
 
Re: Big difference in BG numbers home vs vet

Lori - Just to confirm - when did Maui get insulin? Last night right - nothing today?!

You are getting nice normal numbers and what this means, is that the food change is working, the insulin you have already given is working and the cat is doing great!

DO NOT give insulin as you don't want a hypo situation.

And just to be sure the 42 you got is with NO insulin this morning - correct?!
 
Re: Big difference in BG numbers home vs vet

No, he had his insulin shot about 2.5 or 3 hours ago. I tested him right after he ate and had his shot, and he was 127. I did another test 2 hours later, and the reading was 42. I fed him a bit of gravy-type Fancy Feast and tested again. 49.
 
Re: Big difference in BG numbers home vs vet

Ok - then you have lots of work to do - we need to get him out of the 40's _ please go back to your first post - change the subject to hypo situation - help needed and add the 911 icon - we need more eyes here to help you

here is the process you need to follow - we want to get him over 50 and to stay over 50

1) test every 30 minutes
2) give a one to two teaspoons of gravy only - later on, you can give some food with the gravy - but we don't want Maui to get full too soon

once he is over 50 and you get 3 consecutive rising numbers, you are out of the woods

you may need to give syrup too, but let's try to bring with up gravy to start - please stay online and post the numbers every 30 minutes!
 
Re: Big difference in BG numbers home vs vet

Maui earned a dose decrease and BEFORE giving any more insulin, let's get through this and see what happens, we may suggest skipping next shot.

but one step at a time ok
- please change your subject on the original post - as it is the only thing that people will see and we need to get more help here
 
Re: HYPO situation??? Big difference in BG numbers home vs v

some more information - yes, he can actually go lower and we need to do everything to avoid this, otherwise you will need to take him to the vet to get his bg's up -

is your vet open today? do you know where the emergency vet place is? While you may not need to go, please have this information handy in case you have to take him. The vet would put him on a dextrose IV drip to raise his bg.s

we are going to try to do this with high carb gravy and karo - or any simple sugar you have - what do you have - pancake syrup, karo, honey, melting table sugar in water, jam/jelly, etc?
 
Re: HYPO situation??? Big difference in BG numbers home vs v

Just so I'm up to date...
You gave the shot about 3 hours ago?
And it was 1.0u of Prozinc?
 
Re: HYPO situation??? Big difference in BG numbers home vs v

UPDATE
Here is the situation. This is my first attempt at a glucose cycle.

9:15 ET this morning - fed and got 1 unit Prozinc. Tested immediately after. Reading on Arkray Glucocard was 127
Tested aat 11:15 a.m. -- reading was 42
Fed him Fancy Feast with gravy and tested a few min. later. Reading was 49.

Maui exhibits no signs of being Hypo, other than the low numbers.
 
Re: HYPO situation??? Big difference in BG numbers home vs v

So it's been about an hour since the 49.
Can you test now?
 
Re: HYPO situation??? Big difference in BG numbers home vs v

Not all cats will show signs, that is why testing is key.

and with an initial reading of 127, we would have recommended not giving insulin this morning, since you are so new with this process and we want to always ensure it is safe to give.

Don't focus on doing a curve, because for now, you need to test every 30 minutes and post the numbers to get the cat back up.

All a curve is is testing every 2 hours and well you need to test more because you have a hypo going on and we don't want him going any lower.

You also earned a dose reduction.
 
Re: HYPO situation??? Big difference in BG numbers home vs v

I am going to edit the subject line of your thread so that people can see what's going on at a glance...

Prozinc is most effective in the first six hours after the shot, then it usually begins to taper off. We want to get Maui thru the next three hours and raise the numbers a bit.
 
Re: Maui AMPS~127, +2~41, +2.25~49

Please get another test in now as the gravy can wear off fast, if he is still under 50 or dropping then give 2 tsp of gravy food. We don't want to fill him up as we may need to do this for a while until he is up consistently.

Let us know and get another test in 30...
 
Re: Maui AMPS~127, +2~41, +2.25~49

Tested again at 1pm. 59, but the strip got loaded with blood so we did another right away and it read 64.
 
Re: Maui AMPS~127, +2~41, +2.25~49

Lori

We want to get those numbers back up, so we're going to have you get out some Karo syrup and institute our hypo protocol.

These means break out any karo/honey/maple syrup, an oral syringe, high carb food with gravy if possible, and lots of test strips.

You are going to:
give a few drops of the syrup on the gums
give 1-2 teaspoons of high carb food
wait about 30 minutes
and test
Check the number
And then you're going to repeat that process until Maui is up in safe numbers.



If you back up a few posts, you'll see my post on some reference numbers when using human glucometers.

We treat numbers below 50 fairly assertively, and when they happen before the nadir, we treat them aggressively.

Numbers below 40 we treat as if the cat was hypoing because some cats will show no signs until actively having seizures.
 
Re: Maui AMPS~127, +2~41, +2.25~49

Syrup and gravy don't last very long, so re-test in 30 minutes.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

64 is much better:-)
Can you give Maui another snack and test again in 30-45 minutes?
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

I gave him a spoonful of higher carb Fancy Feast, and tested about 30 min or so afterwards at 2pm. His reading is up to 82 now.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

OK, thats much better. You could probably give a couple teaspoons of mixed higher and lower carb food, to work towards some stabilization without zooming up. And then recheck in another 30-45 minutes.

How are you doing?
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Hows he doing.? Remember the gravy can wear off.

Tonite - no insulin unless over 200 and then at a lower dose - can someone comment on dose? Carl?
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Well, there isn't a protocol for Prozinc like there is for Lantus. There aren't "automatic deductions" at below 50 the same way...

What you know from today is that 1u on a 127 is too much insulin. It dropped Maui 80 points or so in two hours. Too much too soon. It isn't supposed to onset that quickly following a meal. That number might have been a great nadir number, but not a good +2 number.

Personally, I wouldn't advise giving insulin again on a PS as low as 127 (although I did many times, but Bob was "my cat", not somebody else's).

I think 1 unit on a 200 preshot is okay for now. Provided you can test by +3 or +4 to see how low it has gone.

With Prozinc, I believe, you have to look at the preshot number, and the nadir number, and calculate the difference to evaluate the dose. Unfortunately it isn't an exact science.

Onset usually happens around 3 hours after the test and meal.
Nadir can be between +5 and +7 typically.
And you can get 10-14 hours duration out of a shot.
And just like any other insulin, nadir can move, duration can change, and every cat reacts differently. And any one cat can react differently on a day to day basis.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Sorry for lack of an update. We had a couple non-cat related issues to deal with here. We just tested Maui again and he was at 91. His last snack was almost 2 hours ago. I just fed him a bit of his usual Fancy Feast and will test again in a couple hours. The vet is closed today, but I will call them tomorrow and see what he says. I will skip his shot tonight, I guess.

I'm not sure if I completely understand what the "nadir number" is, and how I know what it is if this is the first time I've ever done a glucose cycle with Maui.

Btw...127 was NOT a pre-shot number. It was taken immediately AFTER his shot and food this morning. My vet had instructed me to do the first test 2 hours AFTER his morning shot and food. I misread it and tested immediately after, then did it again after 2 hours and discovered that he'd gone from 127 to 41 in that time. Based on what you all are telling me though, it sounds like I should have done a reading before his shot regardless of what the vet says.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Yes, you should always test before giving the shot, and on that, your vet is dead wrong. The danger in what your vet advised is this - what if Maui's BG had been 75 when you gave the shot? And then he ate, but you didn't test him. At the 2 hour mark, his BG would have been less than zero.... He could have gone into hypoglycemic shock, had a seizure, went into a coma or died.

So you have to know his number is high enough to give him insulin without food in the picture. The way you did it this morning is actually okay, if you fed, shot and tested within minutes. Just the order was wrong. Most people will test, then feed, and give the shot (assuming the number is high enough to give insulin) either just after the cat eats, or while the cat is eating. When Bob was on insulin, the whole "test/feed/shoot" sequence took 10 minutes or less.

"Food" and "insulin" are opposing forces. Food makes the BG go up, and insulin makes it go down. In a case like this morning...what if Maui had decided he didn't much feel like eating? Then there would have been no food in his system to counter the effects of the insulin. In effect, the insulin would act much "stronger". And you may have had to force feed him in order to keep his numbers from going dangerously low.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Oh, to answer your question about what "nadir" is. Nadir is the lowest point that the BG drops to in between one shot and the next. In theory, if a cycle of insulin lasts 12 hours, it should happen around +6 hours after the shot. But cats don't seem to care much about "theory", and the timing of the nadir isn't a sure thing. All sorts of things can affect when it happens, like how much they eat and when during the cycle.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Thanks for all your help today. And to be clear, I do ALWAYS feed first then give the shot. I just am not being clear enough I guess when I'm typing it all for you guys to read. :) This morning he ate, got his shot, and I did his test all within probably 15 minutes start to finish.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

going forward - before you give insulin - please test - if you can test before giving food that will be ideal too - as Carl wrote - the food will cause the bg to rise and it is important to know the bg value without the influence of food or insulin.

this is the only way to know if it is even safe to give insulin. today it wasn't safe.

so please test at his evening "shot time" - before even thinking about giving insulin - if his bg is 200 or less - do not give insulin.

does that make sense?
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64

Makes sense. Thanks! Maui's poor ear is getting sore since I'm still so new to this and have been poking him a lot today.
 
Re: Maui AMPS~127, +2~41, +2.25~49, +3.75~64 +10~91

+10 Maui is still at 91.

The thing about all this that surprised me that most is that Maui's numbers could be so low and he seemed perfectly normal. I almost think I'd feel better if he'd have shown some outward signs that he felt poorly. Now I'm scared that he could seem fine and I could leave for work and he's actually NOT fine. I can't test his blood sugar every 2 hours normally. What should I be doing?
 
well the thing is - he probably did feel just fine - because his levels were in normal range and he felt good - of course had he dropped lower, he could have had very bad symptoms and something we want to avoid.

so for tonight I suggest skipping the shot -

as far as testing goes - you don't have to test every two hours. You must test BEFORE shot time - to determine if it is safe to give insulin

If you give insulin, you will want to test more frequently, just to be able to handle a situation like today. However if you are at work, you can't test - which is why testing before giving insulin is vital. then you can test before going to work, when you get home and once home, you can test as frequently as needed.

If you do give insulin before going to work, you can always give a token dose - meaning 1/2 of what you would normally shoot in order to play it safe since you won't be there to test. You can also leave food out, so if Maui does drop, he can feed himself to help keep his numbers steady.
 
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